Doctoring Differently | Naomi Lawrence-Reid, M.D.
@DocDifferently
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Teaching Doctors how to explore flexible, lucrative physician careers beyond full-time, clinical medicine through digital courses👩🏽💻. NEW PODCAST ➡️🎙️
California, USA
Joined March 2021
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I’m a pediatrician who left full-time clinical academics 6 years ago. I now have 6-7 physician side-gigs that have increased my salary (x5) and allow me to take weeks off at a time.
Nobody told me that I could work this way, but glad I took a chance. It’s paying off.
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I graduated from medical school on June 5, 2011 and I have never had a legally mandated lunch or break during a shift as a physician in the U.S.
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Personally, I don’t want a doctor who has not eaten or taken a break in 12 hours treating me or my family members. And I have been that doctor.
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A strong, collaborative Physician Union that fights for the protection of our bodies and our labor is one of the last ways to make medicine safer for patients and for the doctors who treat them.
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Hospital corporations know and love that we and our nursing colleagues are the public face of their profits and will labor tirelessly for our patients despite our own dangerous fatigue.
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This is not a calling.
This is a job. And I want to be paid for every minute I spend doing it.
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Physicians,
Your hospital doesn’t care about you.
There. I said it.
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Recruiter: “We have a Peds job offering $105/hr! Are you interested?”
Me: “I don’t work for less than $200/hr”
Recruiter: “Why so much?”
Me: “I’m worth it. All pediatricians are”
Recruiter: “Nobody will pay you that much”
Me: “They do and they will”
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I’m a pediatrician who left full-time academics 4 yrs ago. I now have 5-6 Physician side-gigs that have increased my salary (x4) and allow me to take weeks off at a time.
Nobody told me that I could work this way, but glad I took a chance. It’s paying off.
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My neighbor is an architect who designs hospitals and she casually reflected that her latest client’s instructions were to make the C-suite admin offices “palatial” 🏛 while restricting Physician offices to be “as space efficient as possible…”
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Me: [a pediatrician doing veteran disability exams]
70 yr old Black, female veteran: “I have never once had a Doctor who looked like me. You could be my daughter. I’m just so proud of you.”
Whew, these feels 🥲😭😭
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Are you a physician?
Can you write?
Then you are a medical writer and can be paid 300K+ to author regulatory, academic, CME, and communication documents remotely from anywhere in the world.
With internet access, the barriers to medical writing in 2023 are absolutely zero. 🧵
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Remembering the convo with my department chair when I quit full-time academics.
She told me, “This is the best job you’ll ever have. You’re lucky I let you work here. You’ll be back here in a year”
It was not. I was not. It’s been 4 years and counting 💅🏾
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Last summer, I launched a course teaching Doctors how to quit their jobs and find lucrative options outside of full-time medicine.
My first “student”? My own PCP 😂
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This is not a travel account, but I’m a pediatrician who left full-time academics 5 yrs ago after my boss told me I’d never have the schedule or income I knew that I deserved.
Anyways, I’m taking 2 months to travel across Europe and just got to Greece 🇬🇷
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A pediatrician colleague who worked tirelessly at a hosp corporation for 15+ yrs recently died.
2 weeks later we got an email about it. No memorial or grief support offered…
These hospitals don’t care about our lives. Go be happy by any means necessary.
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I asked about Physician lounges. She gave me a blank stare and said, “Yeah hospitals aren’t really doing those anymore.”
Keeping Physicians dangerously busy, tired, and isolated from one another is no accident. They planned for it in the blueprint.
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My hourly rates as a pediatrician in Southern California:
Clinical pediatrics: $105/hr
Locums: $2,000 per 24 hr call + $200/hr for every hr worked.
VA disability: ~$250/hr
Aesthetics: ~$650/hr
(revenue - expenses = profit)
Expert witness, consulting, and writing: $700/hr
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A pediatrician with intensive care experience being offered $55/hr.
Accepting this rate hurts all of us. If we’ll work for less, we’ll never be paid more.
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I was taught, “Don’t have gaps in your resumé. There can’t be any interruptions in your work history after residency.”
Now that I’m building my team, I LOOK for gaps in the resumés of new hires. I want to hear about extended rest, travel, or the pursuit of a passion project.
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Physicians,
You can take a break. You can quit. You can pivot to another type of work. You are not stuck.
There are so many ways we can use our skills and knowledge in flexible, lucrative careers outside of full-time clinical medicine.
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She went on to say, “Most doctors never ask for more money. They just take what we offer”.
Ask for more money. 20-30% more. You’re not a selfish Doctor. You still care about your patients. You cost more because you’re worth more.
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Doctors who quit bad jobs are still doctors.
Doctors who work less are still doctors.
Doctors who take time off are still doctors.
Doctors who decide to work non-clinically are still doctors.
Doctors who choose to put themselves and their families first are still doctors.
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I’ve done remote consulting for VA disability for a year (yes, as a pediatrician) and I just called them to say my rate was increasing from $250/hr to $350/hr. They said no problem.
Then got a call from a peds recruiter offering $74/hr to resuscitate newborns on weekends.
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Walking into my pediatric ER shift at an academic center with over 1 Billion in annual revenue to find that instead of replacing broken doctor’s chairs, admin fixed them with diapers.
Submitted my resignation that night.
What experience in the workplace radicalized you?
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On Monday, the nurses are going on strike and the doctors have been volun-told to do RN duties in addition to their own while working longer shifts.
Physician 👏🏾 Union 👏🏾
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A hospital recruiter recently offered me $75/hr to resuscitate newborns on weekends (non-negotiable rate, “best he could do”).
When I replied that I charge $600/hr for medical expert witness work from home, he said “Thank you for your time” and hung up.
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My first medical expert witness gig paid me a retainer of $4500 for 10 hrs of chart review 🤯.
These are rarely malpractice cases against other physicians. I’m often simply asked to translate medical records for a legal team.
You are an expert. Try it!
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Good doctors can negotiate their contracts.
Good doctors can demand to be paid more money.
Good doctors can demand verbal terms in writing.
Good doctors can carve boundaries btw themselves and their jobs.
Good doctors can learn new skills that they weren’t taught in training.
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When I finished residency, I was explicitly told, “Don’t even try to negotiate your contract or your salary. It doesn’t work for physicians.”
And that is how my starting salary as a pediatrician in 2014 was $125,000.
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Peds hospitalist fellowships are the fyre fest of med education.
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When I quit my academic pediatrician job after 3 miserable years, my department chair told me:
- This is the best job you’ll ever have (salary was 125K/yr).
- You’re so lucky to work here.
- You’ll be back in 1 year begging for this job back.
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I’m a pediatrician, but in the first 4 months of the year, I earned an additional $41,750 through remote medical writing and expert witness contracts.
I charge between $450-$700/hr to research various medical topics and summarize them along with my opinions.
How I started 👇🏾
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Doctors are allowed to quit their jobs too.
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When I quit full-time clinical medicine, my dept chair told me, “If it was that great out there, everyone would be doing it”.
It is that great out here. Everyone should be doing it. We can all have the Physician careers we deserve.
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I would have gladly exchanged 1 of the 10 weeks off I had off at the end of med school for a course that taught about me about malpractice insurance.
Interns can be sued Day 1 of residency (and every day henceforth) so this omission in med education seems egregiously negligent.
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I am helping med students starting residency with their moving costs.
Email me at MedMove
@doctoringdifferently
.com with your name, med school, new residency program (a copy of your match letter would be helpful), and if you’re experiencing any financial hardship (student loans).
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@BlackSheepAwake
Most docs are paid a flat salary no matter what procedure they do. Hospital administrators and insurance companies make 12-20x what doctors earn if you’re ever curious as to why healthcare costs are so ridiculously and exorbitantly high 📈
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I am helping med students starting residency with their moving costs.
Email me at drnaomi
@doctoringdifferently
.com with your name, med school, new residency program (match letter would be helpful), and if you’re experiencing any financial hardship (loans).
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You don’t have to do a fellowship.
You can, but you don’t have to.
If you love the science, the medicine, and the patients within the specialty, do the fellowship.
If you think specializing will make your life better and make you more valuable, it won’t. Please don’t.
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Yes, I’m in it for the money.
You don’t want a doctor who would do this for free (or for the last recruiter email offer that hit my inbox—$62/hr).
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Working as a pediatrician at different institutions entirely on my schedule and negotiated pay rates is so exciting. No day is the same. Thanks to my glove compartment for supporting my locums/per-diem lifestyle.
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Saying it’s a “calling” implies some sort of spiritual exemption to being paid fairly, treated equitably, and having our labor protected in the workplace.
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I used to worry that I wouldn’t be seen as a “real doctor” if I quit full-time clinical medicine.
But now that I set my own schedule, negotiate my own (high) salaries, and only participate in projects that are important to me, I’ve never felt more real 😎
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- That was 6 years ago.
- I have more than quadrupled my income outside of full-time clinical medicine.
- I feel lucky that I trusted myself and my belief that there were exciting, lucrative career options for doctors beyond full-time clinical medicine. There are many.
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I’ve gotten a huge influx of new followers today and not sure why. Is there a conference going on somewhere?
But welcome! I’m a pediatrician who wanted to make a lot of money on my own schedule so I did.
I tweet about how physicians can create good lives and great careers. 🌞
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An OB/Gyn physician job posting offering $45/hour (via LinkedIn).
@comphealth
would you comment below why you believe that an a Obstetrician/Gynecologist deserves to be paid $45/hr?
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12 years ago, I heard lots of, “Congrats on matching into peds! Too bad you won’t make any money.”
That same messaging continued in residency so it took me some time to realize that I have the same right to a high income as any other specialty.
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I was 13 yrs old when I wanted to become a Doctor.
27 yrs old when I became a Doctor.
33 yrs old when I wanted to be anything BUT a Doctor (burnout, debt, etc.)
34-38 yrs old when I discovered how to create my own career.
Now the Best is Yet To Come 💫
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Why I’m so vocal about my salary:
1. Accurate physician salary data is hard to find.
2. This lack of wage transparency allows for large pay gaps btw colleagues even at the same institution.
3. I want all physicians to have a data point by which to negotiate their own rates.
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Good Morning,
A(nother) fellowship or degree will not make you happier.
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My career options in residency:
1. Full-time inpatient peds
2. Full-time outpatient peds
My career options now:
1. Per-diem
2. Locums
3. Expert witness
4. Consulting
5. Veteran disability
6. Medical writing
7. Aesthetics
8. Social Security
9. Course creator
10.Anything I want
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@PSU_Sunshine
Per-diem, locums, Aesthetics (Botox/filler practice), telemedicine, medical expert witness work, veteran disability exams (yes, peds can see Vets!). And now I coach other docs how to do it too.
So 7 gigs now? Doesn’t feel like it. I love the variety. ☺️
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Know your worth then add tax and an inconvenience fee.
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And I refused to buy into the “You won’t ever make real money as a pediatrician” adage. I wanted to make “real” money so I did.
Pediatricians and primary care docs have every right to be top earners.
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When I graduated from residency, my assistant program director told our class, “Don’t even try to negotiate your salary. It doesn’t work for doctors”.
And that is how my starting full-time pediatrician salary in 2014 was $125,000.
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Physicians are groomed (in our formative 20’s) to keep our heads down & learn the medicine, but prohibited from any money/business talk. Our debt, work ethic, & loyalty to patients are systematically exploited to keep us laboring in service of corporations (FDA, pharma, etc).
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Happy Doctor’s Day to doctors who:
- work full-time
- work part-time
- work clinically
- work non-clinically
- don’t work at all
- are considering a career shift, but unsure of their next move.
You can create your dream career from wherever you are. We all deserve good lives.
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Because it’s been awhile…
A(nother) fellowship or degree will not make you happier.
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Despite having almost $200,000 in educational debt, it was strongly implied that if I cared about my salary, I must not care about my patients.
I was made to feel helpless and powerless against the machine of medical academia.
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At no point in my training was I taught how to navigate a physician career—how to find a job, how to interview, how to read a contract. I wasn’t even taught the details of my malpractice insurance policy.
The implication was, “Good doctors should only care about the medicine”.
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Doctors,
You have permission to try new things—new jobs, new pursuits, new interests. Your skills are transferrable to a variety of industries.
There is absolutely no rule that you must stay in full-time clinical medicine for your entire career.
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Hospital administrators, insurers, pharma, FDA, etc figured this gaslighting trick out long ago…
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Our labor generates trillions in corporate profits. And yes, even academic hospitals are for-profit corporations.
Our quality of life? Humane schedule? Mental health? Livable wage:debt ratio? Job satisfaction? They could not care less.
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Learning the Krebs cycle in med school was important, but arguably learning about malpractice insurance and how interns can be sued Day 1 of residency would’ve been equally valuable.
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Because every Doctor should know their job options outside of full-time clinical medicine, here is my working list:
All are legitimate. All are still Doctoring.
1. Per-diem
2. Locums
3. Expert Witness
4. Aesthetics
5. Medical Writing
6. Tech Consulting
7. Veteran Disability
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@olsonplanner
My starting full-time salary in 2014 was 125K (gen peds working in a peds ER). I quit in 2017 and began doing a bunch of physician “side-gigs”— per-diem, locums, expert witness, aesthetics, vet disability, social security. In 2021, I made 450K in 10 months (took the summer off).
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In medical academia, “protected time” = we’ll give you time to do your job and you should feel so lucky.
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Doctors can reinvent themselves at any point in their careers. It’s never too late to be happy.
🙋♂️ What’s your unpopular opinion in medicine that will get you in this position?
#MedTwitter
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We physicians (esp peds and primary care) are groomed to believe that demanding a high (or livable wage) salary means that we care about our patients less.
Med education, hosp corporations, and insurers propagate that lie to protect the trillions they make off of our labor.
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Per-diem is Doctoring
Locums is Doctoring
Pharma is Doctoring
Aesthetics is Doctoring
Expert Witness is Doctoring
Tech Consulting is Doctoring
Veteran Disability is Doctoring
Physicians using their degrees outside of full-time clinical, academic medicine is still Doctoring.
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My advice to medical students,
Pick a specialty where the medicine, science, and patients motivate and excite you.
You can be a high-earning physician with a flexible, autonomous schedule from any specialty.
Sincerely,
A Pediatrician who made it happen.
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My mentors and colleagues repeatedly told me, “There is no legitimate work for physicians outside of clinical medicine.”
That is not true.
Any physician in any specialty has flexible, lucrative career options outside of full-time clinical medicine.
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@birdsofpaper
That part 😡. And the physician offices are basically a closet with a desk and one chair. My neighbor even asked where confidential conversations with patients would occur and she was told, “Oh they can just talk in the exam room”.
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I turned 40 last week and am celebrating on a month-long European tour. 🌍
I never thought this life could be possible for a general pediatrician who began her career with educational debt and a starting salary of $125,000.
Anyways, I just got to Budapest and it’s amazing. 🇭🇺
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Create a profile with the American Medical Writers Association , upload your bio and portfolio, and companies (often in manufacturing, pharma, medical devices, biotech) can find you for employed or contracted work.
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Physicians are taught, tested, and essentially hazed (residency) into learning the JUST the medicine.
The money/business of medicine are intentionally excluded from every part of our medical education so that we never know how much profit our labor generates. Period.
Yesterday a physician who is in a CMO role and who I respect highly said this:
“Most physicians know medicine but don’t understand the business of healthcare”
Agree? Disagree? Discuss
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I have 2 goals for my career:
1. Be a great pediatrician.
2. Make a lot of money being a great pediatrician.
I was taught that
#2
was ok for other specialties, but impossible for me.
Turns out, it’s very possible.
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I’m simply trying to do my part to reverse the toxicity of this work-to-death culture in healthcare. This system runs on our labor, but we do have agency. We are not helpless.
All of us doing something does something.
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I teach physicians about flexible, lucrative career paths outside of full-time clinical medicine.
Follow me or check out for more.
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One fellowship is enough. I beg.
Med education will dice our training through PGY 10-15 if we don’t draw the line somewhere…
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It took leaving full-time clinical medicine and spending the last 6 years exploring the MANY ways that physicians can work flexibly while commanding high salaries to teach me that I’m still a great doctor. We all are. We deserve good lives.
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Results of a survey of my friends who responded to a random text about lounges on Mothers’s Day:
100% of outpatient primary care docs never had a dedicated Physician Lounge.
70% of inpatient docs knew of an MD lounge, but too far/too busy to ever go.
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Physicians can learn new skills
Physicians can learn new skills
Physicians can learn new skills
Physicians can learn new skills
Physicians can learn new skills
Physicians can learn new skills
Physicians can learn new skills
Physicians can learn new skills
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Doctors are good at business.
Doctors can understand finances.
Doctors can lead healthcare, not just medicine.
Doctors can create their own autonomous, lucrative careers.
Doctors are still doctors whether they choose to practice full-time clinical medicine or not.
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You have permission to leave a bad job. There is a high likelihood that personal happiness and career satisfaction are waiting for you outside of full-time clinical medicine.
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I’ve watched too many physicians be fiercely loyal to institutions who will never reciprocate the devotion. I used to be one of them.
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Residency will teach the medicine, but it is deafeningly silent on teaching how to navigate this MD career.
Clinical, non-clinical, full-time, part-time, per-diem, med expert, disability claims, tech, pharma, aesthetics…make this career what YOU want.
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“But you’re just a pediatrician”
I’m also a medical expert witness, tech & media consultant, medical writer, aesthetic injector, veteran disability examiner, and social security adjudicator.
I imagined a career beyond full-time clinical medicine and found many. You can too.
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You can go part-time.
You can go per-diem.
You can take a break.
You won’t lose your clinical skills.
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My premed advisors didn’t say it
My med school didn’t say it
My residency didn’t say it
My attending jobs didn’t say it
But all doctors CAN create and explore their own flexible, lucrative careers both within and beyond full-time clinical medicine. There are no rules!
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@jrniemeyer
Then you should tweet and advocate for those other jobs that need breaks. The world should know!
I wouldn’t want the doctors and surgeons on their 12th and 20th hours of call without breaks or meals making the critical decisions that determine whether I live or die.
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Remembering my shock when I discovered that I, a pediatrician performing lumbar punctures, I&Ds, and suturing faces in a peds ER, could also safely and legally learn to inject Botox®️ and dermal fillers (on adults).
I thought that aesthetics only belonged to derm and plastics.
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Bad doctor jobs exist.
You don’t have to stay.
You’re allowed to quit.
You’re not a failure.
You’re not a bad doctor.
You have other options.
You deserve a good life.
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If you’re a peds resident considering a peds hospitalist fellowship…
Please don’t.
Email me at drnaomi
@doctoringdifferently
.com and let’s chat about career options that don’t involve spending 2-3 yrs in a fellowship to learn skills you already have.
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A board-certified physician is an expert in their field and fully qualified to participate in medical expert witness work.
- flexible (often fully remote)
- lucrative ($500/hr and more)
- rarely malpractice
- most cases settle (no court/trial)
- interesting critical thinking
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You didn’t take an oath to a hospital corporation.
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I took the MCAT twice
I took my MS1 Biochem test twice
Matched to my 2nd choice program
Took the peds boards twice
Now I’m the founder of
@DocDifferently
and transforming how doctors practice medicine.
To all the matched and unmatched, keep going. It only stops if you stop.
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